All you need to read in the other main journals

摘要

Thrombectomy for stroke: a bigger window: When I read this report of the DEFUSE-3 trial it began to DAWN on me that it was very similar to another trial of late endovascular treatment for stroke that had appeared in the NEJM. DAWN was a multinational trial of thrombectomy for stroke caused by internal carotid or middle cerebral artery occlusion in patients known to be well 6-24 hours earlier, in whom there was evidence of ischaemic, but viable brain tissue. DEFUSE-3 is a very similar trial where the window is 6-16 hours, and it was modified and then terminated for benefit once the preliminary results of DAWN came through. This was smart work: although I don't usually like early termination of trials, in this case it makes sense. The pooled data, merely eyeballed, make a strong case for offering thrombectomy for strokes of this kind, where there is evidence of ischaemic, but salvageable brain tissue well after the traditional thrombolysis window.